Medically reviewed on Feb 14, 2018
Scientific Name(s): Gentiana lutea L. and other species including Gentiana acaulis L. and Gentiana scabra Bunge. Family: Gentianaceae (gentians)
Common Name(s): Gentian (common: European pale, stemless, yellow, or wild gentian), bitter root , bitterwort , felwort , gall weed , gentiana , Radix Gentianae Lutea .
No clinical trials support traditional use of gentian to stimulate appetite, improve digestion, or treat GI complaints. Gentian has also been used as an emmenagogue and to treat wounds, sore throat, arthritic inflammation, and jaundice.
Infusions, decoctions, and macerations of gentian roots and rhizomes have been used as a bitter digestive tonic in doses of 1 to 4 g/day. There are no clinical studies to substantiate this dosage recommendation.
Contraindicated in gastric or duodenal ulcer and hypertension.
Documented adverse effects. Avoid use.
None well documented.
The extract may cause headache, nausea, and vomiting.
Mutagenicity has been demonstrated for methanolic extracts in Salmonella assays. Acute veratrum alkaloid poisoning has been reported due to accidental contamination of gentian preparations by veratrum.
Native to the mountains of central and southern Europe, G. lutea is a perennial herb that grows to 1.8 m with erect stems and smooth, oval leaves. The plant produces a cluster of fragrant orange-yellow flowers. The roots and rhizomes are nearly cylindrical, sometimes branched, varying in thickness from 5 to 40 mm. The root and rhizome portions are longitudinally wrinkled. The color of the rhizomes, ranging from dark brown to light tan, appears to be related to the content of bitter principles, because the darker roots have a more persistent, bitter taste. The roots and rhizomes of G. lutea are used medicinally. 1 , 2 , 3
G. acaulis is a smaller herb with a basal rosette of lance-shaped leaves and generally grows to 10 cm in height. It is native to the European Alps at 914 to 1,524 m above sea level. The entire G. acaulis plant is used medicinally. Numerous species of gentian native to China are used in Chinese traditional medicine. Radix Gentianae Scabrae (known as Chinese or Japanese gentian) is indigenous to Korea, China, and Japan, and contains chemical constituents similar to these of G. lutea . 2
The gentians have been used for centuries as bitters to stimulate the appetite, improve digestion, and treat a variety of GI complaints (eg, diarrhea, heartburn, stomach ache, vomiting). Stemless gentian usually is consumed as a tea or alcoholic extract, such as Angostura bitters. The extracts are used in a variety of foods, cosmetics, and some antismoking products. The plant has been used externally to treat wounds and internally to treat sore throat, arthritic inflammation, and jaundice. Despite the name, the dye gentian violet is not derived from this plant. 2 , 4 , 5
The most characteristic aspect of gentian is its bitter taste imparted by a number of iridoid glycosides, primarily amarogentin, gentiopicrin (about 1.5% in fresh roots), gentiopicroside, and swertiamarin. The speed of drying of the roots affects their properties as medicinal bitters. Slow drying permits enzymatic hydrolysis of gentiopicrin into gentiogenin and glucose, therefore reducing bitterness. Gentian extract is used as a bitter in concentrations of approximately 0.02% in nonalcoholic beverages. The iridoids have been analyzed by thin-layer chromatography, micellar electrokinetic capillary chromatography, and high-performance liquid chromatography mass spectrometry. 6 , 7 , 8
In addition to iridoids, the roots contain xanthones and triterpenes. 9 , 10 , 11 The reported pyridine alkaloids gentianine and gentialutine are thought to be artifacts of basic extraction derived from the iridoids. Stemless gentian also contains the xanthone glycoside gentiacauloside. The flowers and leaves of G. lutea contain iridoids, flavonoids, and xanthones. 12
Uses and Pharmacology
Quality clinical trials evaluating the effect of gentian or its chemical constituents are lacking. 2Analgesic/anti-inflammatory
Gentianine and gentiopicroside have been shown to exert a measurable anti-inflammatory and analgesic effect in animals. Extracts of G. lutea were active in carageenan-induced rat paw edema, xylol-induced mouse ear edema, and cotton-pellet granulatoma models. In addition, the extracts were active in several wound-healing models. 13 , 14 , 15Clinical data
Clinical trials are lacking.Antimicrobial
Radix Gentianae Lutea and gentian extracts have been shown to exert antibacterial, antifungal, and antiprotozoal effects in vitro. 2
Methanolic extracts of the flowers and leaves of G. lutea demonstrated a wide range of activity against gram-positive and gram-negative bacteria and yeasts. Isolated chemical constituents mangiferin, isogentisin, and gentiopicrin also demonstrated activity. 16 , 17 Activity against Helicobacter pylori has been demonstrated in vitro. 18 , 19 Amarogentin and 2 other iridoids inhibited topoisomerase I of Leishmania . 20Animal data
The roots of G. lutea have been used as an anthelmintic in ethnoveterinary medicine. 19Clinical data
Clinical trials are lacking.Hepatic effects
In an uncontrolled study, stimulation of gall bladder secretions was increased by gentian. 2GI tract
Bitter substances ingested before meals are reputed to improve the appetite and aid digestion by stimulating the flow of gastric juices and bile. However, because gentian is most often consumed in alcoholic beverages, it is difficult to distinguish the effects of gentian from those of alcohol.Animal data
Ethanol extracts of the roots and rhizomes of G. lutea have increased gastric secretions in rats and sheep. 2Clinical data
In 2 uncontrolled clinical studies, stimulation of gastric secretions was increased and GI symptoms (eg, abdominal pain, constipation, dyspepsia, heartburn) were reduced. 2Other uses
Gentian extracts have hydroxy radical scavenging activity 22 , 23 and exert a protective effect against ketoconazole-induced testicular damage in rats, assumed to be due to antioxidant effects. 24 Gentiopicroside and the essential oil of G. lutea relax smooth muscle in isolated animal trachea and ileum. 2 , 25 Gentian extracts prolong swimming endurance in mice. 26
The pharmacokinetics and tissue distribution of gentiopicroside after oral and parenteral administration have been studied in mice. It was rapidly absorbed with low bioavailability and rapidly cleared. 27 , 28
Infusions, decoctions, and macerations of gentian roots and rhizomes have been used as a bitter digestive tonic in doses of 1 to 4 g/day. There are no clinical studies to substantiate this dosage recommendation. 2
Mutagenic activity has been demonstrated in assays, and G. lutea has been traditionally used as an emmenagogue. Avoid use in pregnancy and lactation. 2
Case reports are lacking; however, hemostatic activity has been demonstrated in vitro for extracts of G. lutea , 29 and isogentisin and several other compounds from gentian inhibited monoamine oxidase. 30 , 31 If substantiated in a clinical setting, these properties may have implications for coadministration of anticoagulant or antidepressant medicines.
The extract is usually taken in very small doses that do not appear to cause adverse effects; however, it may cause GI irritation, resulting in nausea and vomiting and, rarely, headache. 2 Radix Gentianae Lutea is contraindicated in GI or duodenal ulcer. Classical texts include hypertension as a contraindication, but the reasons are difficult to substantiate. 2
Mutagenicity has been demonstrated for methanolic extracts in Salmonella assays. 2
The highly toxic white hellebore ( Veratrum album L.) often grows in close proximity to gentian. Cases of acute veratrum alkaloid poisoning have been reported due to accidental contamination of gentian preparations by veratrum. 32 , 33
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